Original articlePulmonary Circulatory Effects of Norepinephrine in Newborn Infants with Persistent Pulmonary Hypertension
Section snippets
Methods
This observational prospective study was approved by the institutional research ethics committee of Amiens University Hospital. The study was conducted in the Neonatal Intensive Care Units of Lille's and Amiens' University Hospital, France. Newborn infants eligible for inclusion were: 1) >35 weeks' gestation and <1 month old; 2) admitted in the neonatal intensive care unit between Jan 1, 2005, and Dec 31, 2006; 3) received inhaled NO for severe respiratory failure and PPHN; 4) had symptoms of
Results
Eighteen newborns were included in the study (mean gestational age, 37 ± 3 weeks; mean birth weight, 2800 ± 700 g). The mean Apgar score was 6 ± 3 and 8 ± 3 at 1 and 5 minutes after birth, respectively. Respiratory failure was caused by meconium aspiration syndrome in 2 cases, congenital diaphragmatic hernia in 6 cases, and early onset sepsis in 10 cases. The mean O2 requirement was 51% ± 20% at the entry of the study. Each of the newborn infants required vascular expansion with saline or 10%
Discussion
The purpose of this observational study was to investigate the respiratory and the hemodynamic effects of norepinephrine in newborn infants with PPHN and circulatory failure. Although the mechanical ventilatory settings were not changed, we found that the use of norepinephrine was associated with a significant decrease in the oxygen requirement. Despite a rise in both pulmonary and systemic artery pressure, the PAP/SAP ratio decreased after starting norepinephrine. The increase in the blood
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2022, Seminars in Fetal and Neonatal MedicineCitation Excerpt :Whether this beneficial response was due to systemic vasoconstriction or direct pulmonary vasodilation is an area for ongoing investigation. Similarly norepinephrine has been demonstrated to improve PAp:SBP ratios in non-CDH neonatal PN [103]. These systemic vasoconstrictors may improve CDH hemodynamics via a number of mechanisms: